Provider Demographics
NPI:1659973659
Name:NIX, KRISTY JANE
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:JANE
Last Name:NIX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SPRING HOLW
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-0300
Mailing Address - Country:US
Mailing Address - Phone:325-642-6646
Mailing Address - Fax:
Practice Address - Street 1:300 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-1824
Practice Address - Country:US
Practice Address - Phone:325-510-3400
Practice Address - Fax:325-510-3402
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist